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Infection Prevention Q&A–Part 4

Infection Prevention Q&A--Part 4

Question: What are the top FIVE activities in cleaning that will have the greatest impact on safety and health?
Answer: Here is my own list of the top 5 activities necessary to impact the health and safety of the public:
1. Train and re-train Hygiene Specialists™ (housekeepers) that their role is NOT cleaning for appearance sake, but for health’s sake. Train them that there is a science to cleaning and disinfecting and that the Environmental Services (ES) Department performs both the 1) Clinical function of removing and inactivating/killing pathogens that could cause a preventable HAI (Health-care Associated Infection), and, 2) a Practical function of cleaning (NO Dust, NO Spots, NO Smudges, NO Smells=CLEAN).
2. The cost of not performing their job role as directed could cost the Hygiene Specialist’s employer millions of dollars by way of lawsuits. Our patients enter our facilities worried about germs and about getting an infection. We can impact patient satisfaction by allaying those fears while communicating, “While I am here today, I am going to disinfect all the high touch surfaces in your room and then disinfect your rest room before I leave.”  The Hygiene Specialist can also impact HAI rates by doing a good job of providing a safe, clean and disinfected facility that could save their employer MILLIONS!
3. Train those who clean that there is a pattern for cleaning. That is, clean the room from the top-down, and from the cleanest part of the room to the dirtiest, leaving the rest room for last. When cleaning the “patient zone” (the area 3′ or 1 m around the patient’s bed, including the bed rails), use a new, clean cloth.  When done performing that task, ask the patient, “Is there anything I missed?”
4. Never double dip a cleaning cloth. Set up a clean bucket of properly diluted disinfectant at the beginning of the shift and then add 10-15 microfiber cloths to the solution. When it comes time to disinfect hard surfaces, merely reach into the bucket for a clean, disinfectant-charged cloth.  Fold the cloth in half and then half again.  As a surface is cleaned, unfold the cloth to the next unused portion.  Keep doing this systematically until all 8 sides have been used. A good microfiber will “catch micro-soils, but not release them“. NEVER return (double-dip) a soiled cloth into the clean solution because the disinfectant will become contaminated and less effective as time goes on.  By utilizing this method, the same properly diluted disinfectant could last an entire 8-hour shift without having to be changed.
5. Using a quaternary ammonium disinfectant with retired cotton cleaning cloths (such as surgical towels, terry cloth towels and washcloths, T-shirt material) and cotton, string mops is counter-productive and dangerous. Unfortunately, this quat & cotton combination is used in most hospitals and hotels. Cotton inactivates quat disinfectants by binding the active ingredients to the cotton rather than releasing them to the surface. This happens within 5 minutes of introducing cotton wipers or mops to the bucket of properly diluted quat disinfectant. In fact, you might as well be using water after 5 minutes because the ppm (parts per million) of active ingredients in the quat disinfectant is out of specification and in violation of US federal law.
Those are my top 5 activities necessary to impact the health and safety of the public. I welcome your thoughts about an item you think should have made the list, but didn’t.



About Darrel Hicks

J. Darrel Hicks, B.A., is the author of Wiley Publishing's "Infection Prevention For Dummies", and is nationally recognized as one of the top experts in infection control. Darrel Hicks is also the Past President of the IEHA and is an active member in AHE where he holds the designation of CHESP. View all posts by Darrel Hicks

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